2021 Volume 28 Issue 3 Pages 27-30
The patient was a 64-year-old woman. After radiation therapy for squamous cell carcinoma of the vulva and metastasis of the external iliac lymph nodes, a refractory ulcer appeared in the perineum. After being referred to our department for the purpose of pain control, oxycodone was introduced, and the dose of oxycodone sustained-release tablets was increased to 180 mg/day. Since the ulcer was improved by hyperbaric oxygen treatment and the pain was improved by pregabalin, the dose of oxycodone was carefully reduced. Eight months later, oxycodone 20 mg/day was discontinued. A few days later, she complained of diarrhea, restlessness and insomnia, and she used oxycodone for these symptoms. We explained to her that she had opioid withdrawal and treated with suvorexant and intestinal regulator. Her symptoms improved without re-administration of opioids. The careful dose reduction is necessary to prevent withdrawal symptom in the case of the cessation of the opioid.
